Provider Demographics
NPI:1518947209
Name:PEARCY, THOMPSON EMBLETON (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMPSON
Middle Name:EMBLETON
Last Name:PEARCY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 PENNSYLVANIA AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-3389
Mailing Address - Country:US
Mailing Address - Phone:304-344-2241
Mailing Address - Fax:304-344-9562
Practice Address - Street 1:830 PENNSYLVANIA AVE
Practice Address - Street 2:STE 110
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-3302
Practice Address - Country:US
Practice Address - Phone:304-344-2241
Practice Address - Fax:304-344-9562
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10963207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0094068000Medicaid
001712052OtherBLUE CROSS
525489OtherMAMSI
P00229876OtherMEDICARE RAILROAD
160042604OtherUNITED
A71614Medicare UPIN
525489OtherMAMSI